Nationally, average premiums are going up only by low single-digit percentages for 2019. In some states, and for some types of plans, premiums will decline. Fewer areas will see increases. Insurers also are expanding their participation.

There have been changes. It might be more difficult finding help in enrolling, after the Trump administration sharply scaled back funding for sign-up counselors known as “navigators.” Even so, independent community groups still guide consumers through the paperwork.

And in a change that takes effect Jan. 1, those who decide to opt out of health insurance won’t be penalized come tax time.

Consumers have until Dec. 15 to sign up through HealthCare.gov.or visit:www.getcovered.illinois.gov/en

About 10 million people have private policies through HealthCare.gov and state-run insurance markets, with roughly 9 in 10 getting taxpayer-financed help to pay their premiums. An estimated 12 million more are covered through the ACA’s Medicaid expansion, aimed at low-income adults.

Income-based tax credits to help pay premiums remain available. The HealthCare.gov website and call center is up and running. Coverage is available even if you don’t qualify for financial help.

Among the major changes in 2019:
— Repeal of the unpopular requirement that Americans get health insurance or risk fines, gone as of Jan. 1. Experts agree that will reduce enrollment, but differ by how much.

— Greater availability of short-term health plans in most states. The Trump administration is allowing such plans to cover up to 364 days, and renewals up to 36 months. Premiums are much lower than for ACA plans, but pre-existing conditions are excluded and plans don’t have to cover basics like prescription drugs.

— Expansion of “association health plans” for small businesses and sole proprietors. These plans, which can be sold across state lines, are broadly similar to employer insurance. But it takes time to set up provider networks, and to gain approval from state regulators. It’s unclear how widely available they’ll be.

About 11.8 million people signed up during last year’s open enrollment.

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